Healthcare transformation is the hot topic of the day in our country. Politicians are debating it and working on legislation to move it forward. Business leaders are recognizing that they need to be part of the process as healthcare expenses becomes a much larger part of their operational costs. Hospital systems are feverishly working to re-tool their operations to address the need for improved efficiency at reduced cost. Third-party payers are designing new benefit plans which emphasize preventive health services and incentivize high-performing providers and systems. The general public also has found its voice in the process, putting increasing and appropriate pressure on a system that, after all, is supposed to serve the people.
Whatever our new and improved Health Care System ends up looking like, there is one thing we can all agree upon: The people who will be implementing the transformed healthcare system of tomorrow must be educated with the appropriate skills, behaviors, and attitudes to make that system succeed. The challenge then is how do you train workers today for a system that doesn’t even yet exist? The obvious answer is that the educational programs which train the healthcare workforce of the future need to transform in tandem with the industry itself. Transformation in one system needs to inform and drive transformation in the other. One can’t transform before the other. The speed at which change is necessarily taking place is too rapid to allow the drag such an iterative process would have on the change process as a whole.
The good news is that this is exactly what is taking place at the University of Utah Department of Family and Preventive Medicine (DFPM) through its educational programs for Family Medicine residents; Physician Assistant students; Medical students; Occupational Medicine students, residents, researchers; and Public Health professionals. Consistent with the core concept of team care as the expected dominant mode of care for patients in the future, we are also collaborating significantly with other campus educational programs, such as the School of Pharmacy and the College of Health, in transforming the educational systems of today. Some notable examples of how we are undertaking educational and healthcare reform in parallel are the following:
– We are working with the entire U of U Health Sciences Center on an $840M CMS (Medicare and Medicaid) grant to transform clinical practices both within and outside of the University System. The grant is expected to have a major emphasis on utilizing students and DFPM preceptors in the process.
-DFPM is also partnering with many employers, big and small, to design new types of employee health and wellness options that go well beyond simply paying for a health insurance premium. This provides a great opportunity to partner with the many disciplines of the College of Health to design a multi-professional and comprehensive healthcare package that benefits employer and employee alike. Student-providers will be an integral part of these plans.
-Trainees of the Physician Assistant Division, Family Medicine Division, the School of Medicine and the School of Pharmacy have been running a student-run clinic within the Maliheh Clinic, which provides healthcare for the people of Salt Lake City at a much-reduced cost. This clinic is a model of interprofessional, collaborative team care. It thus serves as an example of not only how care will be provided in the future, but how students will be trained for our future health care systems.
In fact, all of the new ventures described above will serve as clinical training sites for our many students to learn in an interprofessional, collaborative way that will serve them well in their healthcare sites of the future.
As I said earlier, healthcare transformation activity is all around us and is advancing rapidly. Educational transformation is not only answering the needs that healthcare transformation is creating, but is also driving it. The creative intellect and energy of our many healthcare students is an awesome force that it is our great pleasure and privilege to access. To do otherwise would be a grand missed opportunity.
John Houchins, MD is an Associate Professor in the Univ of Utah Dept of Family and Preventive Medicine, and is the Chief of the Physician Assistant Division.